State of Connecticut Office of the State Comptroller Health Care in Connecticut: The Uninsured, Health Care Financing, Access and Uncompensated Care Footnotes

State of Connecticut

Footnotes

  1. Source: Morgan Quitno Press. Health Care State Rankings 1996 (Morgan Quitno Corporation, 1996). This figure was generated by comparing the change in Census Bureau estimates for Connecticut's uninsured population from 1991 to 1994, which rose from 7.5 percent to 10.4 percent. Note, these figures differ from those reported above because the Census Bureau measures the uninsured as a percentage of the whole population, not just those under age 65.
  2. Employee Benefit Research Institute. "Sources of Health Insurance and Characteristics of the Uninsured" (February, 1996). Note, the totals do not add to 100 percent because some individuals receive coverage from more than one source.
  3. Henry J. Kaiser Family Foundation. Uninsured in America: Straight Facts on Health Reform (April 1994). Original Source: Lewin/VHI.
  4. Winterbottom, C.; Liska D.; and Obermaier, K. State-Level Databook on Health Care Access and Financing (The Urban Institute, January 1995).
  5. Bourget Research Group. "Connecticut Small Employer Health Reinsurance Pool: 1991 Small Business Health Insurance Attitude and Usage Study (January, 1991).
  6. For purposes of illustration, the 1996 federal poverty level for annual income is: $7,740 for an individual, $10,360 for a couple, $12,980 for a family of three and $15,600 for a family of four.
  7. Short, Pamela Farley and Jessica S. Banthin. "New Estimates of the Underinsured Younger than 65 Years" Journal of the American Medical Association (October 25, 1995).
  8. Short and Banthin characterize policies with lifetime benefits of $10 million or more as "unlimited."
  9. Levit, Katherine R.; Lazenby, Helen C.; and Sivarajan, Lekha. "Health Care Spending in 1994: Slowest in Decades," Health Affairs (Summer 1996).
  10. Ibid.
  11. Aaron, Henry J. "Thinking Straight About Medical Costs" Health Affairs (Winter 1994).
  12. To find PHCE, the line items in Table 1 for research and construction, government public health activities, and program administration and the net cost of private health insurance would be subtracted from national health expenditures.
  13. Levit, Katherine R.; et. al. "State Health Expenditure Accounts: Building Blocks for State Health Spending Analysis" Health Care Financing Review (Fall 1995). Note, this article is the primary source for both the national and Connecticut-specific expenditure data presented in this section.
  14. Arnold, Judith and Jessica Miller (Lewin-ICF). "Pursuing Health Care Reform in Connecticut: Final Report to the Connecticut Health Care Access Commission" (July, 1992).
  15. For consistency with national data presented throughout the report, 1993 personal health care expenditures are presented for Connecticut's Medicaid program. More recent information on total Medicaid spending is available from the Department of Social Services in a July 1995 report titled "Medical Assistance Annual Expenditure Report."
  16. The Henry J. Kaiser Foundation. "Medicaid Special Financing Arrangements: Disproportionate Share Hospital (DSH) Payments, Provider Taxes, and Intergovernmental Transfers" (April, 1995).
  17. Office of Health Care Access. "State Agency Health Expenditures: SFY 1994-1995 Update" (September 6, 1995).
  18. Agency for Health Care Policy and Research. "Use and Cost of Health Services: Effect of Health Insurance and Other Factors" (April, 1993). The study notes that the uninsured very likely postpone preventative and routine care until problems become very serious and are more difficult to treat. It also warns that insured populations may over-use care.
  19. Berk, Marc L., Claudia L. Schur, and Joel C. Cantor. "Ability to Obtain Health Care: Recent Estimates From the Robert Wood Johnson Foundation National Access to Care Survey" Health Affairs (Fall, 1995).
  20. Robert Wood Johnson Foundation. Challenges in Health Care: A Chartbook Perspective (1991).
  21. Baker, L.C. and L.S. Baker. "Excess Cost of Emergency Department Visits for Nonurgent Care" Health Affairs (Winter, 1994).
  22. This section draws heavily on the work of John Kasprak, Senior Attorney with the Connecticut General Assembly's Office of Legislative Research. For a very thorough review of this subject, including funding levels and sources, please see Mr. Kasprak's memorandum of February 15, 1996 regarding the Community Health Centers.
  23. This complicated and controversial subject will not be addressed here, other than to note that significant issues exist. The increased competition for Medicaid reimbursement has reduced revenues to the CHCs and will probably have a negative impact on their ability to serve uninsured individuals.
  24. Lewin, Marion Ein. Building Blocks for Change: How Health Care Reform Affects Our Future, edited by Jack A. Meyer and Sharon Silow-Carroll (The Economic and Social Research Institute, 1993).
  25. Carey, Kevin M. "OHCA Issue Brief: Uncompensated Care in Connecticut" (Office of Health Care Access, March 9, 1995).
  26. Office of Health Care Access. "OHCA Issue Brief No. 5: Hospital Financing and the Uncompensated Care Program" (May 19, 1995).
  27. Carey, Kevin M. "OHCA Issue Brief: Uncompensated Care in Connecticut" (Office of Health Care Access, March 9, 1995).
  28. Office of Health Care Access. "OHCA Issue Brief No. 5: Hospital Financing and the Uncompensated Care Program" (May 19, 1995).
  29. In recent years, the revenues raised by the two hospital assessments have exceeded the amount distributed back to the hospitals. A task force led by the Lieutenant Governor recommended reducing the hospital tax over time to phase out the "overassessment." In response, the legislature passed PA 96-144, which will reduce the hospital gross receipts tax from 11 percent to 9.25 percent on October 1, 1996; to 8.25 percent on October 1, 1997; to 7.25 percent on October 1, 1998; and to 6.25 percent on October 1, 1999. In SFY 1996-97, the additional revenue deposited in the general fund will amount to $40 million.
  30. Mann, Joyce et. al. "Uncompensated Care: Hospitals' Responses to Fiscal Pressures" Health Affairs (Spring, 1995).

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